| NPI | 1568775484 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP 5262) | 
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MN LP5262) | 
| Enumeration Date | 2010-07-20 | 
| Last Update Date | 2024-06-27 |